How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $151.36 | Professional | None | $11.22 | $13.49 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $5.37 Median $6.92 Typical High $7.59 | Facility | None | $5.37 | $6.92 | $7.59 |
Moda Health Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $7.24 | Professional | None | $5.37 | $6.76 | $7.24 |
Pacific Source Setting Facility Modifier None Typical Low $6.46 Median $7.08 Typical High $7.24 | Facility | None | $6.46 | $7.08 | $7.24 |
Providence Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $8.91 | Facility | None | $6.17 | $6.31 | $8.91 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $5.89 Typical High $79.43 | Professional | None | $3.02 | $5.89 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | None | $7.76 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.09 Typical High $6.03 | Professional | None | $2.40 | $3.09 | $6.03 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 54 · Surgery only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 54 · Surgery only | $3.98 | $3.98 | $3.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where Oregon sits
The same service costs 2.7 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 21st of 51
$5.37
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.